MOaH- Women, Midwives and Doctors working together in complex care

Abstract

What was the problem? Women under medical obstetrics (in addition to obstetric/midwifery care) found it difficult to access care: - Multiple appointments, sometimes at different campuses - Main carers for young children - The condition/s themselves - COVID restrictions on outpatient attendances.... ....leading to: - Delay/failure to seek timely care - Condition/s not managed well - Patient becomes more unwell/fetus at increased risk - Requires increased appointments/monitoring/admission/delivery Who is the most disadvantaged group? Looked at women who suffered from conditions associated with: - High FTA's - High number of touch points - Poorer outcomes if not well managed (including physical, psychological and patient experience implications) - Associated antenatal admissions/readmissions Hypertensive Disorders Hyperemesis Gravidarum Engaged consumers to develop improvement plan - "How could we manage their conditions better?" - Care at home as much as possible - Telehealth or home visits - To be taken seriously - To not be waiting hours in ED for treatment - To have timely follow up of interventions to see if they are working - To have someone to talk to regarding symptoms - To not feel like I'm wasting everyone's time when I seek treatment And MOaH (Medical Obstetrics @ Home) was born - Early referral (ED, SSU, GP, ANC, inpatient ward) - Follow up at home organised prior to discharge - Face to Face assement at home weekly/twice weekly until stable - Case review at end of each day with Medical Obstetrics and Midwife - person-centered, individualized treatment planning - Once stable, ongoing care via Telehealth/EVE app Evaluation Mid-evaluation now (March '22)Copyright © 2022